药物滥用和药物依赖预防中的社会心理因素

1 引言 我们生活在一个变幻着的世界中,传统的价值观和社会结构体系在迅速瓦解.今天,人类正面临着历史上最大的一次危机,这一危机也可能成为人类社会发展中的一个转折点.在这变幻和瓦解的过程中,压力和不确定性普遍存在.虽然现代文明和科学技术的进步增加了人们对社会保障的期望,但经济危机、失业以及违法犯罪的增加同样使世界变得难以预测,也加深了社会的焦虑感.当前,普遍存在的吸毒和酗酒问题就是这一困境的反映.这也是隐藏在那些寻求生活真谛的人们心中的一种危机.     

Imbalances in dietary consumption of fatty acids, vegetables, and fruits are associated with risk for Crohn's disease in children

BACKGROUND AND OBJECTIVES: The role of dietary factors in the etiology of Crohn's disease (CD) is inconsistent largely due to difficulties in acquiring valid information on consumption habits. We examined the impact of diet on new onset CD in children using a validated food-frequency questionnaire (FFQ). METHODOLOGY: A case-control study was carried out. Children < or =20 yr, newly diagnosed with CD, were recruited from 3 pediatric gastroenterology clinics across Canada. Population or hospital controls were selected matched to cases for time of diagnosis (+/-6 months) and area of residence. Dietary consumption 1 yr prior to disease diagnosis was evaluated using a validated FFQ, administered within 1 month of diagnosis. Conditional logistic regression analysis adjusting for potential confounding variables (energy intake, age, gender, body mass index) was carried out. RESULTS: A total of 130 CD patients and 202 controls were studied. Mean age at diagnosis (+/-SD) was 14.2 (2.7). There were more male patients (59%). Comparing the highest to the lowest levels of consumption, higher amounts of vegetables (OR 0.69, 95% CI 0.33-1.44, P= 0.03), fruits (OR 0.49, 95% CI 0.25-0.96, P= 0.02), fish (OR 0.46, 95% CI 0.20-1.06, P= 0.02), and dietary fiber (OR 0.12, 95% CI 0.04-0.37, P < 0.001) protected from CD. Consumption of long-chain omega-3 fatty acids (LCN-omega-3) was negatively associated with CD (OR 0.44, 95% CI 0.19-1.00, P < 0.001). A higher ratio of LCN-omega-3/omega-6 fatty acids was significantly associated with lower risks for CD (OR 0.32, 95% CI 0.14-0.71, P= 0.02). CONCLUSIONS: Our findings indicate that an imbalance in consumption of fatty acids, vegetables, and fruits is associated with increased risks for CD among Canadian children.     

Alteration of the langerhans islets in pancreatic cancer patients

Summary An abnormal glucose metabolism occurs in up to 80% of pancreatic cancer patients shortly or a few months before the first clinical admission. Reasons for this abnormality are obscure. We investigated immunohistochemically the pattern of islets in 14 pancreatic cancer specimens and used 14 chronic pancreatitis samples and 10 normal pancreata as controls. To study the topographical relationship of these islets to the cancer, islets in four different arbitrary zones within and around the cancer were evaluated. Ten out of 14 cancer specimens showed a significant loss of β cells (p<0.005) and eight of them also showed a significant increase of α cells (p<0.005), all of them from hyperglycemic patients. Most affected islets were found within zone 1 (intratumoral) and zone 2 (peritumoral), to a lesser extent in zone 3 (acini close to tumor) and none in zone 4 (acini remote from tumor). No comparable changes were found in chronic pancreatitis patients. The incidence of 72% with alteration of islets in our material correlates with the frequency of abnormal glucose levels in human pancreatic cancer patients. Our findings support the notion that islet cell abnormalities is likely caused by substances released from cancer cells.     

Angiogenesis Therapy for the Treatment of Erectile Dysfunction

IntroductionOver the past 15 years, significant advances have been made in the treatment of erectile dysfunction (ED). The most significant of these advances has been pharmacological treatment of ED with phosphodiesterase type 5 (PDE5) inhibitors. This therapy greatly increased the awareness of ED and has helped stimulate research into the underlying causes of ED. While treatment with PDE5 inhibitors continues to be the current therapy of choice, approximately 40% of men treated with PDE5 inhibitors fail to have significant improvement in erectile function and PDE5 inhibitors do not reverse the vasculopathic processes associated with ED. With this in mind, new therapies must be developed. The treatment with angiogenic growth factors such as vascular endothelial cell growth factor (VEGF) may be one such therapy.AimThis review will focus on defining key terms in the angiogenic process, angiogenic growth factors, and different delivery methods, and summarize results from angiogenic therapies for the treatment of ED.MethodsA review of the literature was performed on all angiogenic therapies for the treatment of ED. A brief review on the angiogenic factors was also performedResultsAngiogenic therapies for the treatment of ED are possible and promising; however, further investigation is needed to advance clinically.ConclusionsAlthough numerous studies have now employed angiogenic factors for the possible treatment of ED in several animal models, we are still not at the point to begin human investigations. Future studies need to examine proper dosage of the angiogenic agent, route of delivery, time course for delivery, and combination therapies. Lysiak JJ, Kavoussi PK, Ellati RT, Steers WD, and Annex BH. Angiogenesis therapy for the treatment of erectile dysfunction.     

The Role of Decreased Retinoblastoma Protein Expression in Acute Myelomonocytic and Monoblastic Leukemias

The results of different investigators show that lack of p 105 expression is relatively common in human myeloid leukemias, especially in monocytic leukemias. This suggests that loss of p105 expression could contribute to the altered growth control of these cells. So far no clear data exist which show that low p105 levels in AML blasts predict a poor therapy outcome. Therefore it is not very likely that p105 expression will become a strong prognostic factor for the different treatment strategies in AML.     

Neuropsychiatric complications of interferons: classification, neurochemical bases, and management.

BACKGROUND: Recombinant interferons are widely used for a number of serious illnesses. However, their use is sometimes associated with severe and disabling neuropsychiatric side effects. METHODS: A MEDLINE search identified pertinent laboratory investigations, case reports, clinical studies and letters published between 1983 and 2004 in the English language journals. The studies in which interferons were used in combination with other cytokines were excluded. RESULTS: The interferon-associated neuropsychiatric side effects are divided into mood-related symptoms (depression/mania), cognitive impairment (including delirium), psychosis and isolated psychiatric symptoms. Putative neurotransmitters (serotonin and dopamine), hormones (cortisol) and cyokines (interleukin-2 and 6) have been implicated in the pathophysiology of these side effects. Management of neuropsychiatric side effects of interferons ranges from supportive measures, dose reduction, cessation of therapy and the use of appropriate psychotropic agents. CONCLUSIONS: Interferon-treated patients should be monitored for mental status changes. There are no controlled studies on pharmacological management of interferon-induced neuropsychiatric side effects. The use of interferons in patients with stable psychiatric disorders is not contraindicated. However, such patients should be closely monitored during the course of treatment with interferons.